PROJECT SUMMARY/ABSTRACT This proposal describes a five-year research training program that will allow me to achieve my long-term goal of becoming an independent faculty-scientist dedicated to improving healthcare quality and patient health for youth with diabetes. The majority of adolescents with type 1 diabetes (T1D) in the United States are not meeting the goals of therapy. I propose to develop tools to provide innovative diabetes management support to adolescents outside of the clinic setting through the use of social media (SM) and evaluate its feasibility and acceptability to adolescents with T1D. SM has become an integral part of adolescents? lives and at this time, there is an absence of high quality empirical studies investigating the use of SM in the healthcare setting. Given the need for impactful interventions to support adolescent T1D management, this work has the potential to result in a major advance for disease management in this vulnerable population. The goal of this proposal is to develop a patient-centered SM intervention that will enhance patient self-efficacy and improve health outcomes for adolescents with T1D. I will achieve this goal by first identifying several different SM intervention strategies for distinct segments of adolescents with diabetes. In Aim 1, I plan to conduct a survey of a large sample of adolescents with T1D to examine perceptions on how SM can be utilized in diabetes management and then using latent class analysis techniques, I will segment adolescents based on patient characteristics and preferences around the use of SM. In Aim 2, I will incorporate additional stakeholder input, including caregivers and healthcare team members, through the use of user-centered design workshops to develop a pilot SM intervention based on previous formative work. By engaging adolescents, caregivers, and healthcare team members in an iterative process of user-centered design workshops I hope to develop a SM intervention that is consistent with key stakeholder values, preferences and goals. In Aim 3, I will pilot the SM intervention in a randomized controlled trial and examine its feasibility and acceptability. In addition, I plan to explore the impact on patient-reported outcomes (e.g. self-efficacy) and glycemic control. My research will be supported by an outstanding group of mentors with expertise in social media research, pediatric diabetes, survey research, and the design of clinical interventions. By accomplishing the aims in this proposal, I will address current gaps in our understanding of how to leverage SM to support adolescents with chronic disease. In addition, this proposal will allow me to take the next critical steps on my research training trajectory by providing me the opportunity to acquire additional research skills required to design, evaluate and implement behavioral health interventions using social media. Ultimately, this proposal will allow me to build a research program to investigate system-oriented, patient-centered solutions to improve the delivery and quality of medical care to youth with diabetes.!